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[Accidental falls in nursing homes. A study of the extent and circumstances of accidental falls in nursing homes].

Accidental falls in 54 nursing homes with 2228 elderly residents aged 65 years and over were registered during a period of seven months. During the seven months, 512 of the elderly residents fell on a total of 934 occasions. Forty-two fractures of the neck of the femur occurred. The risk of falls for elderly residents of nursing homes is very high, but the majority of falls do not result in permanent damage. In this investigation, no differences could be demonstrated between staff groups or circumstances concerning falls with and without resultant damage. All falls should be regarded as warnings and result in detailed investigation of the circumstances of the fall in view of prophylactic measures. Accidental falls are caused by a complex interaction between a series of health, therapy, furnishing and attitudes. Various circumstances are emphasized in this investigation which are connected with an increased risk of falling, e.g. vertigo, problems of balance, certain aids and activities in connection with toileting.

Accidental Falls↗

[Accidental falls in nursing homes. A study on the role of drugs in accidental falls in nursing homes].

The drug consumptions of 2228 residents in nursing homes aged 65 years and over were investigated and related to accidental falls during a period of seven months. 95% of the residents received treatment with one or more drugs and 33% with six or more drugs. The risk of accidental falls was significantly increased in persons receiving hypnotics, psychomarmaca and anti-Parkinson medicine. Individuals receiving diuretics, particularly thiazides, were less at risk for accidental falls. This investigation revealed an increased risk of falls particularly when residents were receiving treatment with a short-term hypnotic (Triazolam). It is recommended that this finding should be investigated further.

Accidental Falls↗

Accidental falls and injuries among seniors.

This study analyzes data on accidental falls for those aged 65 and older. The data are based on mortality statistics from 1980 to 1989 and morbidity statistics from 1985 to 1989. These statistics are provided to the Canadian Centre for Health Information by the provincial governments. Mortality rates and hospital separation rates for accidental falls are highest for those aged 65 and older. Accidents are one of the leading causes of death and hospitalization among seniors. In 1989, for those aged 65 and older, accidental falls accounted for 56% of accidental deaths and 65% of accident-related hospital separations. Mortality and hospital separation rates for accidental falls increased with age. For those aged 65 and older, the mortality rates for accidental falls were higher for men than women. However, the accident-related hospital separation rate was higher for women than men. The reason for this difference is not fully understood, but it has been suggested that while more women fall than men, more men seriously injure themselves. For men requiring hospitalization due to accidental falls, the most common injuries, in descending order, were fractures of the hip, ribs, vertebral column, humerus, and pelvis. For women, the most common injuries were fractures of the hip, humerus, radius and ulna, pelvis, and ankle. Of fall-related injuries resulting in hospitalization, hip fractures were the leading cause of death and proportionately more men than women died of hip fractures.

Accidental Falls↗

[Accidental falls in homes for the aged].

Accidental falls among residents of homes for the elderly have only received scanty notice in the literature. During a period of 15 months, 296 falls among 1,856 residents of homes for the elderly were analyzed prospectively. The age-specific incidences for falls and fractures of the neck of the femur which are treated in hospital were found to be higher for residents of homes for the elderly as compared with elderly persons living at home in the age group 65-85 years. Residents of homes for the elderly who constitute 7% of all ages over 65 years are responsible for 21% of all accidental falls and 32% of all the lower limb fractures treated in hospital.

Accidental Falls↗

[Physical causes of accidental falls among the elderly in their own homes].

Accidental falls in elderly persons involve considerable illness and great hospital costs. During the period 1971-1986, the incidence has risen from 14 to 19 per 1000 annually. Four hundred and seventy-three individuals aged 60 years or more who had fallen in their own homes and who sought help in Odense Hospital after the accident were interviewed consecutively. The replies to these interviews described the circumstances involved in the fall together with the health and social conditions. Women constituted 78% of the material with preponderance of people living alone as compared with the background population. Just under half of the patients had had a previous fall. Fractures were sustained in 40% of the cases. In 51% of the cases, a definite or probable external circumstance was the cause of the fall. In 150 out of 237 accidental falls, caused by external circumstances, the accident was considered to have been preventable by means of eg more accessible lighting, non-slip carpeting, removal of doorsteps, more suitable arrangement of furniture and better supportive measures beside stairs. The risk of falling is found to increase markedly in persons aged 75 years or more. Prophylactic measures are recommended before patients reach this age by means of information to elderly persons and to persons involved in home care about situations involving risks.

Accidental Falls↗

Severity of injuries due to accidental fall across the life span: a retrospective hospital-based study.

This retrospective study investigated injuries due to accidental fall across the life span for which 19,593 patients were admitted to the Emergency Unit of the Groningen University Hospital during the period 1990 through 1997. 64% of the accidental falls were found for those in the age range between 10 years and 59 years; however, the proportion of accidental falls with regard to other causes of injuries by age group were the highest in youngsters (infants up to 9 years old) and in elderly persons (over 60 years old), 43% or more of these patients having falls with injuries. The clinically treated patients had on the average a statistically greater Injury Severity Score (7.2) than the outpatients (2.4). The highest percentages of medically treated inpatients were the patients of 60 years and over. Their mean ISS score was about the same for elderly inpatients, but the percentage of clinical treatment increased with age as well as the mortality. 30% of the injuries were found in the lower extremities and 30% in the upper extremities. Bone fracture was statistically significantly the major (36%) injury followed by contusion (20%). 34% of the accidental falls occurred at home, and statistically significantly more females, 50 years of age and older, were injured than males.

Accidental Falls↗

Mortality from accidental falls among the elderly in the United States, 1962-1988: demonstrating the impact of improved trauma management.

Falls in elderly persons primarily occur because of increasing intrinsic frailty rather than extrinsic environmental hazards. Thus declining mortality from accidental falls in the elderly predominantly reflects improved trauma management rather than injury prevention. Mortality attributed to accidental falls among individuals aged 60 to 85 years in the United States from 1962 through 1988 was analyzed using the Strehler-Mildvan modification of the Gompertz relationship of aging and mortality. This method of analysis can be used to define a disorder-specific age at which etiopathogenic influences are directly proportional to the mortality rate. From 1962 through 1988, the mortality rates (per 100,000) from accidental falls in the United States declined 63.5% (from 165.6 to 60.4) among men at age 83.4 years, and declined 76.3% (from 86.2 to 20.4) among women at age 77.5 years. This analysis suggests that trauma management, at the population level, was 2.74 times more effective in men and 4.22 times more effective in women at reducing mortality from accidental falls among the elderly in 1988 than in 1962.

Accident Prevention↗

Accidental falls among geriatric patients: can more be prevented?

The potential for accidental falls among geriatric patients is of mounting concern. Two hundred forty-one accidental falls over a 12-month period at the VA Medical Center were analyzed retrospectively and the literature reviewed in order to highlight factors that have bearing on the incidence and severity of falls. If a patient's potential for falling could be identified through a grading system based on these premonitory features, preventive measures might be more clearly focused where needed to reduce this frequent hazard in our hospital population.

Accident Prevention↗

Alcohol consumption and mortality rates from traffic accidents, accidental falls, and other accidents in 14 European countries.

AIMS: To evaluate the effects of changes in aggregate alcohol consumption on fatal motor vehicle traffic accidents, accidental falls, and other accidents in 14 western European countries after 1950, and to compare traditional beer, wine and spirits countries. DESIGN, SETTING AND PARTICIPANTS: The countries were sorted into three groups. Gender-specific, age-adjusted annual mortality rates (15-69 years) were analysed in relation to per capita alcohol consumption, utilizing the Box-Jenkins technique for time series analysis. All series were different to remove long-term trends. The results of the analyses of individual countries were pooled within each group of countries to increase the statistical power. MEASUREMENTS: Overall accident mortality data for 5-year age groups were converted to age-adjusted mortality rates for the age group 15-69 years, using a European standard population. Data on per capita alcohol consumption were converted to consumption per inhabitant 15 years and older. FINDINGS: For male accidental falls, the analyses uncovered a statistically significant association with alcohol consumption in northern and central Europe, but not in southern Europe. Among females the association was insignificant in all regions. For male traffic accidents, significant relationships were uncovered in central and southern Europe, but not in northern Europe. Among females the effect was significant only in central Europe. For the remaining fatal accidents a significant relationship was found for north European males only. CONCLUSION: The association between aggregate alcohol consumption and rates of fatal accidents is mainly due to traffic accidents in central and southern Europe, and to falls and other accidents in northern Europe.

Accidental Falls↗

[Injuries due to falls from a great height. A comparative analysis of injuries and their outcome following suicide-related and accidental falls].

The aim of this study was to compare the outcome and clinical course of multiple trauma patients with accidental or intentional (suicide related) fall from heights > 4 m. 211 patients with an injury severity score (ISS) > 17 were assigned to the following groups: I: intentional fall, n = 94; A: accidental fall, n = 117) and ISS (I: 28 +/- 1; A: 30 +/- 1), ventilation time (I: 16 +/- 2; A: 15 +/- 1) were not different. Significant differences were found in sex (m/f: I: 56/44; A: 73/27%), fractures of lumbarspine (I: 34; A: 15%), pelvis (I: 51; A: 38%), lower leg (I: 47; A: 20%), pilon (I: 15; A: 5%), and os calcis (I: 17; A: 9%). Liver lacerations occurred more often after intentional fall (I: 16; A: 6%). Single or multiple organ failure (MOF) was diagnosed significantly more often in group A(I: 1; A: 8%). Main cause of death in both groups was single or multiple organ failure (MOF: I: 47; A: 69%) or related to brain-injuries (I: 35; A: 19%). Prognosis and rehabilitation of multiple trauma patients after intentional fall is related to brain-injuries, spine-fractures and the functional outcome of the injured lower leg. Prognosis of patients after accidental fall is related to the development of MOF during the ICU-course.

Accidental Falls↗

The role of alcohol in accidental falls.

Fifty-three percent of patients injured in accidental falls in the evening in Helsinki and 15% of time-, site- and sex-matched control pedestrians were alcohol-involved. Relative risk of injury, if 1.0 at zero BAC, was 3 at BACS 60-100 mg/100 ml, 10 at 101-150 mg/100 ml and about 60 at BACS above that.

Accident Proneness↗